Chronically ill, comatose, debilitated, elderly, or other bedridden patients frequently assume a contracted, fetal-like position wherein the legs are upwardly drawn and bent at the knees. Such upwardly drawn, knee-bent positioning of the legs over an extended period of time may result in atrophy of the leg muscles and/or other degenerative changes in the knee-joint-associated ligaments and tendons.
A number of orthotic appliances have heretofore been utilized to treat knee contracture by straightening the leg at the knee joint. One example of a knee-extension, orthotic appliance currently used in the art is the ProGlide.TM. (L.M.B. Hand Rehab. Products, Inc., San Luis Obispo, Calif.). Such orthotic devices may also permit bending of the knee joint when desired. Such devices commonly comprise a spring-hinge attached to the leg at points immediately above and below the knee. Attachment is typically via leg surrounding members such as straps or the like. Such leg surrounding members or straps are typically secured around the leg by way of buckles, hook and loop attachment tabs (e.g., VELCRO.TM.) or other tightening hardware capable of holding the appliance in its desired position on the leg. The tension of the spring-hinge disposed proximate the knee joint thus urges the leg into an extended position.
One problem associated with these knee-extending orthotic devices of the prior art is the vertical (superior or inferior) shifting or slippage of the device despite reasonably secure tightening of the leg surrounding member or straps to the affixation points above and below the knee. In an effort to overcome the inherent tendency of such appliances to undergo vertical (e.g., superior or inferior) shifting or slippage, it is common to over tighten the leg surrounding members or straps about the patients thigh and calf.
Such tightening of the leg surrounding member or straps may be accomplished to a point where the appliance becomes generally uncomfortable for the patient and reduces circulation in the patient's leg or causes breakdown of sensitive skin. Decubitus ulcers may form if the device is worn for extended periods of time.
Similar devices have been commonly utilized as braces to provide support to a knee joint after an operation and/or injury. Although structurally similar, such braces typically lack a spring for urging the leg into an extended position. Thus, such devices are not optimal for use as leg extension maintaining orthotic appliances, since they do not allow the patient's knee to be volitionally bent when so desired. One example of such a leg brace is the K.M.D. Post-Op Brace manufactured by Innovation Sports, Inc. of Irvine, Calif.
Furthermore, chronically ill or bedridden patients tend to be susceptible to a condition known as "drop foot" or "foot drop" wherein the foot hangs in a plantar-flexed position due to neuro-muscular atrophy and/or lesions of the peroneal nerve. Drop foot and plantar flexion deformities have been known to develop in patients who spend substantial amounts of time lying in bed with the lower leg/ankle allowed to hang in a flaccid position. Traditionally, such plantar flexion deformities are known to develop in patients who have suffered strokes or other debilitating conditions. One mode of treating and/or preventing plantar flexion deformities of the ankle is to splint or immobilize the ankle of the flaccid leg such that a controlled degree of dorsiflexion of the foot will be maintained. Various splints and splint-like devices have been provided for accomplishing such immobilization of the ankle. Typically, the splints and splint-like devices have comprised generally L-shaped members, attachable to the lower leg and foot so as to hold the foot at or in an approximately 90-degree angle to the lower leg.
In addition to being useable for the prevention of and/or treatment of plantar flexion deformities in chronically ill or debilitated patients, foot splints and devices have also been used for various other therapeutic purposes including immobilization of the leg and foot to facilitate healing following traumatic injury and/or surgery.
One example of a splint device is that disclosed in U.S. Pat. No. 5,020,523 (Bodine), issued on Jun. 4, 1991, the entirety of which expressly incorporated herein by reference.
In view of the inherent deficiencies of the prior art, it is desirable to provide a knee-extending orthotic appliance need not be fastened so tightly around the leg as to cause discomfort or to, adversely affect circulation, and/or cause decubitus ulcers. It is also be desirable to provide a knee-extending orthopedic appliance having a removable foot orthosis component which may be used alone or in conjunction with the knee-extending component of the device to prevent degeneration changes in the lower leg, ankle and foot. (e.g., foot drop)